More Pittsburghers want to become death doulas

Americans don’t know how to die well. We plan for everything from births to weddings to careers, but when it comes to death, many are woefully unprepared.

Death doulas in Pittsburgh want that to change. According to the International End of Life Doula Association, death doulas are educators, advocates, and supporters for the dying and their loved ones.

They can help families to talk with one another frankly about death, ease the burden on caregivers by coordinating logistics, explain the dying process, provide emotional and spiritual support, and more. What they can’t do is provide medical care or medical advice.

Much like a birth doula supports the entrance into life, a death doula supports the transition out of it; but unlike birth doulas, death doulas operate largely unregulated. Even without a universal definition of what a death doula does, required certification, or standard pathway to becoming one, interest continues to grow.

Helen Stickney, a death doula/death companion since 2017, didn’t start out in this field. “I was the typical American,” she tells Pittsburgh City Paper. “I knew nothing about death.” While working as a professor at the University of Pittsburgh, she began volunteering in hospice, offering Reiki and meditation. What started as curiosity turned into a calling, and she left academia for a career in hospice administration.

“I wanted to help people die,” she says. But soon she realized that holding the hands of the dying wasn’t her job — it was the family’s. Her role was to support them, helping them navigate the murky and emotional terrain of death. After completing a doula certification program, she needed support from fellow doulas. “This isn’t something I want to do solo,” she emphasizes.

Stickney found other doulas in the area and hosted a death café — a community gathering where people talk openly about death — at her home. It’s part of a larger death-positive movement aimed at normalizing end-of-life conversations. From there, she and other death deathcare enthusiasts formed Pittsburgh Community Deathcare (PCD), to support one another and offer a centralized service for people looking for doulas.

Each doula at PCD offers their own unique services. Stickney focuses on logistics, family support, meditation, and deep listening, but doesn’t offer legacy projects or post-death care. And like any responsible death doula, she does not offer medical care. She urges anyone looking for a death doula to do their homework and interview prospective doulas.

Above all, pre-planning is crucial. “When a loved one gets a terminal diagnosis, that’s not the time to figure that out,” she says.

Despite the rising interest, she says death doulas in Pittsburgh aren’t making a living doing this. Her group gets just three or four service inquiries a year, but they get that many calls per month from people wanting to become doulas. “It’s definitely not a career,” says Stickney.

Another PCD member, Lynne Ireland-Knight, hadn’t planned to become a death doula. In November 2018, her oldest son was diagnosed with colorectal cancer. He died in March 2021 at the age of 31.

“Promise me, Momma, you’re going to take care of yourself,” he told her. The same year he died, she earned a death doula certificate from the University of Vermont. In his honor, she created Promise Me Momma, her own doula practice.

“There can be a good death,” Ireland-Knight tells City Paper. “Plan for your death and talk about it … No one makes a good decision in a crisis.”

This fall, Ireland-Knight will teach death doula education at the Community College of Allegheny County (CCAC). It’s the first course of its kind at the college.

The curriculum covers spiritual and emotional support, the dying process, communication, family engagement, and more. Specific modules include intro to end-of-life care, foundation of doula practices, the dying process, communication skills, practical support techniques, working with families and caregivers, and case studies. The 45-hour program begins Sept. 16 and costs $1,800. In the end, students will receive a certificate of completion.

While geared toward healthcare professionals, the course is open to anyone. “We just don’t have the staff [in hospitals] to cover all of this,” CCAC Healthcare Programs Specialist, Lauren Wharton, tells CP. And, since many people are caring for dying people at home, this course can give them the knowledge they need for a good death, Wharton says.

But what constitutes a good death? That depends on who you ask.

The death doula community is far from monolithic. Individual philosophies, techniques, offerings, and even opinions about the field vary widely, especially without an oversight body.

Nisha Bowman, a licensed social worker, palliative care and hospice social worker, and death educator, and is skeptical about the commercialization of death doulas. Bowman works full time in palliative care, and she’s a part of PCD, but considers herself a deathwalker, a term with ancient roots that predates the doula trend.

There’s no common definition of what a death doula is, and Bowman says that’s a problem.

Many people, she believes, are drawn to death doula work with good intentions, without realizing what it entails or the demand that exists. “Being a death doula really calls to this nurturing part of ourselves — in all people, because every person has masculine and feminine aspects of their personality.

“In a time where so many people need to be tended to, it seems like an easy way to do that,” Bowman tells CP.

While death doulas can help fill a gap in the system, Bowman fears the field is becoming co-opted by capitalism. “It just feels like the death doulas have become an MLM kind of thing,” she says.

Bowman says many invest time and money in training courses, then realize there’s not enough work, so they become trainers themselves. CCAC, on the other hand, says the course is suited for people looking to make a full-time career of it.

According to a study published in the National Library of Medicine surveying over 600 end-of-life doulas, 91.4% were white, 90.4% were women, and 70.1% were employed in other ways to make a living.

“There’s a level of privilege to this work,” says Bowman. Too many people that need deathcare the most can’t afford it. What started out as an organic practice to help community members in need is becoming more entrenched in the medical system and costs a significant amount of money, Bowman explains.

Instead, she says mutual aid — trading resources or services — help those without financial means receive deathcare assistance.

“My fear is, it’s becoming such a bougie, white-washed, cute side hustle,” says Bowman. “Where has the depth gone?”

She encourages people interested in deathcare to start with hospice volunteering and learn what it really means to work with the dying and the people in their lives. “Helping someone die is so much more than holding space for them,” she says.

[Editor’s note: A few details in this story were updated for accuracy after publication, including Nisha Bowman’s certifications and roles, and the description of who makes up the PCD.]

This article appears in Aug 13-19, 2025.